Parosteal osteosarcoma: Report of a rare juxtacortical variant of osteosarcoma affecting the maxilla.

Parosteal osteosarcomas are rare, low-grade juxtacortical variant of osteosarcoma, especially in the jaws, representing 1.6% of all bony malignant tumours and upto 5% of all osteosarcomas. Only 12 cases of intraoral parosteal osteosarcomas have been reported in the English literature. In the jaws males are more commonly affected with peak occurrence at 39 years and nearly equal site predilection for maxilla and mandible. Radiographically, parosteal osteosarcomas are radiodense, lobulated masses with a broad stalk to the cortex of the bone with no periosteal reaction and medullary invasion. Microscopically, shows well-differentiated tumor with minimum atypia and rare mitotic figures separating trabeculae of woven bone. Unlike classical and periosteal osteosarcoma, it is considered to have a good prognosis. A case report of this rare entity in 22-year-old female patient with bony hard, painless swelling of 9 months duration in maxillary premolar-molar region is presented. The need for differential diagnostic approach is emphasized from other seemingly benign clinical entities.

Osteosarcoma with atypical location in an elderly female patient.

Osteosarcoma most frequently affects long bones, particularly around the knee, and is therefore rare in the forearm. We report the case of a 67-year-old woman presenting with progressive lesion of the distal radius. A pathological diagnosis of osteoblastic osteosarcoma was suspected and was confirmed by needle biopsy. There had been two other cases of osteosarcoma in the same family. The patient was treated with neoadjuvant chemotherapy followed by amputation of the arm below the elbow.

Juxtacortical osteosarcoma of mandible.

This article presents a case of juxtacortical (paraosteal) osteosarcoma in a 43-year-old female, which is rare malignant mesenchymal tumor. As per the literature, it accounts for less than 4% of all osteosarcomas. Due to its rare variety, this tumor can cause diagnostic dilemma and clinicians should be aware of it. Due to its clinical picture, it can be confused with peripheral fibro-osseous lesions. Success rate of treatment are good if the tumor is detected early and resected with wide margins giving a negligible chance for recurrence.

Periosteal Osteosarcoma Of The Mandible: Report Of A Case

Juxtacortical osteogenic sarcoma of chondroblastic type on the maxilla / 대한구강악안면방사선학회지

39-year-old female had been treated for the exophytic mass on buccal aspect of the left maxillary posterior area 2 years and 8 months ago. Tentative diagnosis was obtained as fibrous dysplasia on clinical and radiographic examinations and histopathologic findings revealed as osteochondroma after bone trimming at that time. She revisited for the treatment of recurred lesions. We reviewed this case with clinical, radiologic and histopathologic standpoints retrospectively, and came to a conclusion that the tumor primarily occurred was juxtacortical osteogenic sarcoma and recurred due to inadequate treatment and then expanded over intramedullary. This case shows that the diagnosis of osteosarcoma should take account of the patient history, clinical, radiographic and histopathologic findings and it requires attentive follow up check. Retrospectively reviewed results were as follows ; At first visit, oral examination revealed a bony hard swelling on the buccal aspect of the left maxillary posterior area. Radiographically, a dense radiopaque mass was noted on the site. The lesion showed hot uptake of 99mTc-MDP. Histopathologic diagnosis was done as osteochondroma, but it was considered as osteogenic sarcoma when compared with the recurrent lesion. When she revisited for the treatment of multiple bony swelling on the left maxilla, radiograms showed typical features of malignancy such as widening of periodontal ligament space and sun-ray appearace, and coincided with benign characters as follows ; relatively well circumscribed lesion and expansion and displacement of the adjacent structures. Finally, histopathologic findings of the lesion was well differentiated chondroblastic osteogenic sarcoma.